Objectives: 

We developed a simulation-based educational tool to teach medical students the evolution and complications of an acute myocardial infarction (AMI), and to assess their theoretical knowledge, reaction time, practical and teamwork abilities. Our motivation was to incorporate in our Faculty of Medicine the spirit of the Bologna declaration

Materials: 

We simulated several clinical cases of AMI and generate a realistic time course of physiological variables (arterial PO2, blood and atrial pressures, etc) with the Human program (T. Coleman, Univ. Mississippi, USA, freely available on the internet at Skidmore College; http://placid.skidmore.edu/human). For Simman simulations, we used real ECG electrodes, blood pressure cuff, assorted material for IV, CPR protocol, defibrillator and manual ventilation.

Results: 

The scenario shows the time course of cardiovascular parameters during the first hours following a myocardial infarction. We simulated heart failures ranging from 75% to 30% of cardiac efficiency. The level of cardiac failure was correlated precisely with the clinical case under study. Within the scenario the student had to diagnose and propose treatment by critical analysis of the ECG and cardiovascular conditions (blood pressure, heart rate, central venous pressure, ventilation, blood gases, etc.). The students also were trained in advance CPR techniques. We put special emphasis in the correlation of level of heart failure with easily accesible physiological variables and their time course in order to aware students of the importance of clinical evolution.

Conclusions: 

The complementary use of the detailed analysis provided by the Human program on physiological variables, a realistic manikin and clinical study cases help students to better understand the key physiological concepts, diagnostics and treatment of an AMI. In addition, students get acquantied in medical practice and teamwork. This approach reinforce theoretical physiological knowledge and shortens the time of assimilation of medical concepts.

*First three authors contributed equally